Unlocking Accountable Care: Recent Episodes
Day Health Strategies
Day Health Strategies is a woman-owned, mission-driven consulting firm whose mission is to transform the healthcare system by making it more patient-centered, affordable, and high-performing.
Lori Russell is the Executive Director for Aspire Developmental Services, a non-profit organization based on the North Shore, which focuses on providing early intervention services for children.
In this episode, Lori shares with us the societal impacts of the COVID-19 pandemic, particularly as they relate to educational regression among children who are unable to participate in daycare and/or early intervention services as a result of safety regulations. Lori describes the ways her organization has shifted to accommodate various needs that have arisen in the community at this time. She also shares ideas for how on-profits who serve young children can revamp their programs and operations to mitigate the negative consequences of children not being able to engage in traditional learning activities.
Gustavo Torrez is recognized nationally as a leader in the tobacco prevention and control movement with a focus on youth and young adult populations. He is the Director of Youth Advocacy at The Campaign for Tobacco-Free Kids, an organization devoted to leading the fight to reduce tobacco use and its deadly toll in the United States and around the world.
In this episode, Gustavo describes the various ways he empowers young people to become involved in policy and advocacy. He discusses an online educational platform he launched for young people to learn fundamental skills to strengthen their ability to advocate for and implement lasting changes locally and nationally.
Maria Levis, CEO of Impactivo, is committed to transforming health systems to ensure access and health for vulnerable populations. She specializes in innovation, health systems research, strategy development, policy analysis, implementation sciences, patient centered medical home transformation, quality improvement, public health emergencies and value-based health care projects in New York, Washington DC, and Puerto Rico.
In this episode, Maria discusses her most recent work researching and implementing equitable, evidence-based interventions in healthcare. She specifically highlights her work in providing high quality telehealth services to vulnerable populations and describes how she uses readiness assessments to help focus her work and to provide high quality, targeted care.
Emily had the pleasure of interviewing Jonathan Payne, Senior Consultant at Regenstrief Institute & Digital Impact Alliance at the UN Foundation and Director at Open Concept Lab.
Listen as Jonathan draws from his background working in low-resource settings and explains why high-income settings often struggle to adjust and adapt to advances in digital health technology. He discusses the lessons we can learn about COVID-19 and introduces the concept of global goods – digital health tools that are adaptable to different countries and contexts. Jonathan also describes the Open Concept Lab, a platform he designed to collect, standardize, and report health measures between countries.
This episode features Jim Tate, Chief Product Officer at MediVisum Telehealth Solutions, based in Chapel Hill, North Carolina. Jim has overseen large-scale implementations of electronic health systems in various hospitals and healthcare institutions across the United States and Asia.
Listen as Jim discusses the changes in digital health technology in light of the COVID-19 pandemic. He talks through the rapid shifts in regulations and policies governing service provision – such as expanding telehealth services and their respective reimbursement rates – and speculates on which changes will remain long after the public health emergency is over.
On our most recent episode of Unlocking Accountable Care, Emily had the opportunity to interview Kavita Bouknight, CEO and Co-Founder of Match Health Academy.
Kavita shares about Match Health Academy – an online learning platform with self-paced courses designed to help patients and their families improve their understanding of health conditions, drive awareness of available treatment options, and provide access to helpful resources.
Listen as Kavita shares her personal vision for her business and the pivotal role consumer-facing platforms play in improving health outcomes.
Our host, Emily George, spoke with Linda Schwimmer, President and CEO of the New Jersey Health Care Quality Institute. Linda is responsible for driving policies that advance health care safety, access and affordability. She is well-known for her commitment to drive lasting change that improves health care for every person in New Jersey.
In this podcast, Linda shares more about her work and experience with small group employers within the state of New Jersey. She discusses the steep decline in the small group market, drivers, implications, and ways in which to offer stability to curb the negative impact of these shifts.
Taiwan has been recognized globally for their well-coordinated and timely response to the COVID-19 pandemic, despite being close to the Wuhan epicenter where the virus originated.
In this episode, Kathy Laytham, an American family nurse practitioner who has practiced clinically in a variety of settings for the last 17 years in Taiwan, discusses the variety of ways government and public health officials targeted institutions, communities, and individuals to ensure the health and well-being of their citizens.
Recorded on June 25, 2020
This episode features Lisa Bielamowicz, president and co-founder of Gist Healthcare – a membership organization for health systems and physician groups to share learnings and best practices, and receive strategic advice for building capacity to better serve their communities.
Lisa a national expert in delivery transformation and a trusted advisor to hundreds of health systems and physician networks. In this podcast, Lisa elaborates on how the COVID-19 pandemic has impacted small physician networks and larger health systems, and shares invaluable advice on strategies that can be applied in the short-term and long-term to ensure sustainability.
Recorded on: May 5, 2020
In this podcast, with guest host Niko Lehman-White, you'll hear from Elizabeth Mitchell, CEO of Pacific Business Group on Health (PBGH), about PBGH's hands-on work with its clients and participating health systems, including clinical transformations, a Centers of Excellence network, and innovative payment models. And the results for their patients, who have better experiences, fewer readmissions and infections, and lower costs, lends credence to the concept she frequently brings up: that better care costs less.
This episode features Chris Allen, former CEO of Authority Health, based in Wayne County, Michigan – an organization that strives to meet the unmet health and social needs of communities by helping individuals enroll in insurance and navigate the health system.
Listen as Chris shares his passion for facilitating understanding of the ways in which “power of place” like an individual’s zip code, skin color, and/or socio-economic status determine individuals’ life expectancy and health outcomes. He discusses the history of redlining and other discriminatory policies that have had long-term negative outcomes, particularly for African Americans within the U.S
In this episode we hear from Dr. Bill Berry, Co-founder of Ariadne Labs, as he discusses how provider communications around patient safety have evolved alongside managed care. Listen as Dr. Berry provides insightful recommendations for how healthcare leaders can turn policy into meaningful action.
In this episode we hear from Julian Dormitzer, Nurse Practitioner and Biomedical Research Team Manager at Fenway Health. Julian's provides direct, patient-centered care to LGBTQ youth living with, or at-risk for, HIV. Listen as Julian discusses her strides to increase access to culturally competent care in communities serving LGBTQ populations.
Join us for a special episode with Charles Gaba, founder of ACASignups.net, a website which live-tracks Affordable Care Act (ACA) enrollments since the exchanges launched in October 2013. His work has been cited as being the most reliable source available for up-to-date, accurate ACA enrollment data in the country. Listen as Charles discusses considerations for the future of the ACA in light of the COVID-19 pandemic and upcoming presidential election.
In this episode we hear from Harold Cox, Associate Dean for Public Health Practice and Associate Professor of Community Health Sciences at Boston University School of Public Health. Listen as Dean Cox describes how Massachusetts state policy ensures that the building and expansion of health care facilities reflect the needs of the communities they serve.
Join us for a special episode with Rosemarie Day, Founder and CEO of Day Health Strategies. As the first COO of the Massachusetts Health Connector, Rosemarie recounts successes and challenges in establishing near-universal insurance coverage across the state. She also describes how this experience motivated her to write her newly- released book: Marching Toward Coverage: How Women Can Lead the Fight For Universal Healthcare.
In this episode we hear from Mary Fleming, former Chief of Staff at Substance Abuse and Mental Health Services Administration (SAMHSA). Drawing on over 30 years of experience in the behavioral health field, Mary shares how we should be thinking about the issues surrounding mental and behavioral health. She offers her take on the next steps for significant policy reform towards integrated care.
In this episode we hear from Dr. David Jones, Associate Professor in the Department of Health Law, Policy and Management at the Boston University School of Public Health. An expert in health care politics, Dr. Jones explains the history and importance of bipartisan support in health policy and discusses how it relates to his current research on social determinants of health and health equity in the U.S.
In this episode, we sit down with Dr. Ann Hwang, Director, and Mark Rukavina, Business Development Manager of the Center for Consumer Engagement in Health Innovation at Community Catalyst. The Center works with advocates, academics, state and federal policymakers, and industry stakeholders to examine problems and identify practical solutions to creating more person-centered and community-minded care.
In this episode, Emily sits down with Jeffrey (JD) Syrek, Vice President of System Contracting and Contract Finance at The New England Quality Care Alliance (NEQCA) and Tufts Medical Center. With over 25 years’ experience in healthcare financing, provider incentives and contracting, JD shares important considerations for insurers and healthcare systems as they work to achieve successful ACO implementation.
In this week's episode, we sit down with Michele Sasso, Director of Clinical Programs and Technology and Rebekah Diamond, Director of Policy and Business Relations for the Department of Accountable Care and Clinical Integration at Boston Children's Hospital. They speak about the challenges and intricacies of running a pediatric ACO program and how their newly formed department seeks to put patient needs first.
The New England Quality Care Alliance (NEQCA) is a partnership of community and academic physicians dedicated to providing comprehensive, innovative, high quality and affordable health care. As Chief Financial Officer, Nate Gagne is accountable for the performance of NEQCA’s accounting, finance and information technology departments. Nate explains his role and how his team strives to provide better care, better health, lower cost and higher clinician satisfaction.
Yvonne LeBlanc, Manager of Pharmacy Operations for New England Quality Care Alliance (NEQCA), discusses the role of pharmacists in accountable care. This episode explores how clinical pharmacists are underutilized despite what we now know about their ability to help contain total cost of care for patients and ensure high quality of care – and how ACOs can better leverage pharmacy resources to impact their populations."
In this episode, we hear from Mike Cannella, Assistant General Counsel for the Massachusetts Health Connector. Prior to his current role, Cannella served as the Legislative Director and Counsel for Massachusetts State Senator James T. Welch. This episode is packed with interesting insights into Massachusetts’ legislative efforts to restructure the state’s Medicaid program.
Fred Goldstein, President & Founder of Accountable Health, shares his thoughts about giving communities a mechanism to create interventions to improve their own health. In the value-based world, health care providers are trying to keep people healthy and are incentivized to do so, but what if we shift some of that responsibility and those incentive dollars to the communities themselves?
Clay Farris, Practice Lead of Mostly Medicaid, joins us to talk about the national Medicaid landscape. He discusses value-based care in Medicaid, how to succeed as a Medicaid ACO, and what to expect moving forward.
Dr. John Sargent, Chief of Child and Adolescent Psychiatry at Tufts Medical Center, discusses the importance of behavioral health care as an integrated component of primary care and his role as a pediatric psychiatry consultant to primary care physicians and care teams in a Medicaid Accountable Care Organization. We dive into how an ACO can ensure that patients are receiving the right level of behavioral health care at the right time.
Learn about the role community based organizations play in serving patients with high needs and the imperative for these community partners and ACOs to partner to provide care coordination and care management for patients with severe mental illness. Our own, Lisette Roman sits down with Mary Takach from Boston Healthcare for the Homeless to learn about their efforts to care for the homeless population in a risk-based environment.
Hear Dr. Corey Waller, a national addiction expert, discuss what the health care system can be doing better to treat substance use disorders, why ACOs should be focusing on addiction, and how addiction can be successfully treated as a chronic disease.
Interdisciplinary case management can not only lower total cost of care, but also improve patients' lives. Our own Sarah Matousek sits down with a case management team to learn about how the MassHealth Medicaid program is allowing them to use meaningful interventions.
Connecting with community organizations allows providers to better coordinate care, meet patient needs, and provide services in an accessible way. Sarah and Shelia discuss the importance of community connections for community health.
The financial incentives and alternative payment model details play a key role in determining the impact and success of Accountable Care Organizations. Sarah and Dr. Seeley discuss the current financial structures and what trends we are likely to see.
As an ER physician, Dr. Thea James has long been a leading voice advocating for hospitals to invest in addressing the root causes of health that drive people to show up in her ER. In this episode, we will hear about the powerful programs that Dr. James and Boston Medical Center have invested in to improve social determinants of health for patients they serve in Boston.
Doctors are increasingly being pulled in multiple directions based on whether they are still being paid a flat fee for every service they provide, given a lump sum per patient or procedure, or are being asked to focus on the health of an entire patient population. Dr. Namita Mohta and Sarah dive into how providers and healthcare organizations today can navigate these conflicting incentives.
Insurers and providers often see each other as adversaries, but ACO arrangements offer a unique opportunity to align interests and bring them onto the same team. Sarah sits down with Mike Nickey of Fallon Health to discuss how insurers and providers are being more collaborative than ever to implement value-based care.
Dr. John McDonough has been on the forefront of health reform for the better part of three decades – working intimately on the design and passage of both Massachusetts’ landmark 2006 healthcare law and later the Affordable Care Act. In this episode, John sits down with Sarah to discuss what value-based care means for the delivery of medicine, how we got here, and what makes MassHealth’s Medicaid ACO approach unique.
- Yvonne LeBlanc, Manager of Pharmacy Operations for New England Quality Care Alliance (NEQCA), discusses the role of pharmacists in accountable care. This episode explores how clinical pharmacists are underutilized despite what we now know about their ability to help contain total cost of care for patients and ensure high quality of care – and how ACOs can better leverage pharmacy resources to impact their populations.
Clay Farris, Practice Lead of Mostly Medicaid, joins us to talk about the national Medicaid landscape. He discusses value-based care in Medicaid, how to succeed as a Medicaid ACO, and what to expect moving forward.
Dr. John Sargent, Chief of Child and Adolescent Psychiatry at Tufts Medical Center, discusses the importance of behavioral health care as an integrated component of primary care and his role as a pediatric psychiatry consultant to primary care physicians and care teams in a Medicaid Accountable Care Organization. We dive into how an ACO can ensure that patients are receiving the right level of behavioral health care at the right time.
Interdisciplinary case management can not only lower total cost of care, but also improve patients' lives. Our own Sarah Matousek sits down with a case management team to learn about how the MassHealth Medicaid program is allowing them to use meaningful interventions.
The financial incentives and alternative payment model details play a key role in determining the impact and success of Accountable Care Organizations. Sarah and Dr. Seeley discuss the current financial structures and what trends we are likely to see.
Comprehensively collecting and analyzing patient data can give providers a more complete picture of their patient’s health and better direct care and resources. In this episode, we hear how one innovative MassHealth ACO is using data and highlight best practices for all organizations transitioning to value-based care.
Insurers and providers often see each other as adversaries, but ACO arrangements offer a unique opportunity to align interests and bring them onto the same team. Sarah sits down with Mike Nickey of Fallon Health to discuss how insurers and providers are being more collaborative than ever to implement value-based care.
Dr. John McDonough has been on the forefront of health reform for the better part of three decades – working intimately on the design and passage of both Massachusetts’ landmark 2006 healthcare law and later the Affordable Care Act. In this episode, John sits down with Sarah to discuss what value-based care means for the delivery of medicine, how we got here, and what makes MassHealth’s Medicaid ACO approach unique.